Complications

Type and frequency of complications depends on the age and the immunity of the patient (1).

• Infants and children:
  • pertussis may be responsible for serious and potentially life-threatening complications in infants and young children who are not fully vaccinated
  • severe complications and deaths occur mostly in infants under six months of age (2)
  • some of the complications include:
    • apnea
    • bronchopneumonia
      • the most common complication and cause of death
      • usually secondary to bacterial infection with Streptococcus pneumoniae, Staphylococcus aureus, or Haemophilus influenzae
    • seizures
    • encephalopathy - due to hypoxia from coughing or possibly from toxin
    • refractory pulmonary hypertension
    • epistaxis
    • otitis media
    • dehydration
    • severe complications like pneumothorax, rectal prolapse, and subdural hematomas (1)
• Adolescents and adults:
  • less severe (especially those who have been vaccinated)
  • common complications observed in studies of adults with pertussis include:
    • pneumonia
    • weight loss
    • urinary incontinence
    • syncope
    • rib fractures from severe coughing (1)

Longer term complications include:

• bronchiectasis

Reference:

• (1) Heininger U. Pertussis: what the pediatric infectious disease specialist should know. Pediatr Infect Dis J. 2012;31(1):78-9.
• (2) Public Health England (PHE). Pertussis brief for healthcare professionals